|Consultation on STD Interventions for Preventing HIV: What is the evidence? (UNAIDS, 2000, 60 p.)|
In any population, only a certain proportion of those with symptomatic STDs will be cured by the health services. This cure rate depends on a set of factors (proportions or probabilities):
- number of persons with symptomatic STDs/reproductive tract infections (RTIs);
- proportion of these aware and worried;
- proportion seeking care;
- proportion correctly diagnosed;
- proportion receiving correct treatment;
- proportion completing treatment;
- proportion cured.
As shown in the hypothetical example of Figure 1, the fraction achieving cure may be very small because at each step patients are lost. However, it must be noted that each step is different for different population groups, as well as for their particular environmental circumstances.
Figure 1 Operational model of the role of health services in STD case management
The overall goal of interventions designed to address this operational model is to increase the number of patients with STD who attain cure. This can be achieved by making the population aware of disease symptoms (where present), and encouraging them to seek adequate care early, thus helping improve patients treatment-seeking behaviour. Furthermore, improving the diagnostic skills of health workers and their prescription practices can strengthen case management. The availability of effective drugs is also essential, as is the provision of health education messages aiming at better compliance in completing prescribed drug treatment regimens.